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Presumed Mechanisms Underlying Lipoprotein(a)-caused Atherosclerosis

Annalisa Filtz1, Leandro Slipczuk1, Martha Gulati2,3

  • 1Cardiology Division, Montefiore Medical Center/Albert Einstein College of Medicine Bronx, NY, US.

European Cardiology
|March 16, 2026
PubMed

Insights

Lipoprotein(a) (Lp(a)) is a key risk factor for cardiovascular disease. Understanding its role in atherosclerosis development and progression is vital for new therapies.

Area of Science:

  • Cardiovascular Biology
  • Atherosclerosis Research
  • Lipid Metabolism

Background:

  • Lipoprotein(a) (Lp(a)) is an established, independent risk factor for atherosclerotic cardiovascular disease.
  • The precise mechanisms by which Lp(a) contributes to atherogenesis are still being elucidated.
  • Lp(a) plays a multifaceted role in the development and progression of arterial plaque.

Purpose of the Study:

  • To review and synthesize the current understanding of Lipoprotein(a) (Lp(a))'s role in atherogenesis.
  • To highlight the biological mechanisms through which Lp(a) influences cardiovascular disease.
  • To underscore the importance of Lp(a) biology for future therapeutic strategies.

Main Methods:

  • Literature review of existing studies on Lipoprotein(a) (Lp(a)) and atherosclerosis.
  • Analysis of evidence supporting Lp(a)'s contribution to endothelial dysfunction, inflammation, and lipid retention.
  • Examination of Lp(a)'s prothrombotic effects and impact on fibrinolysis.

Main Results:

  • Lp(a) promotes endothelial dysfunction, vascular inflammation, and lipid accumulation in the arterial wall.
  • Lp(a) drives foam cell formation and smooth muscle cell activation, key early events in plaque development.
  • Lp(a) interferes with fibrinolysis, increasing thrombosis risk and potential for plaque rupture.

Conclusions:

  • Lipoprotein(a) (Lp(a)) contributes significantly to both the initiation and advancement of atherosclerosis through multiple interconnected pathways.
  • A comprehensive grasp of Lp(a) biology is crucial for developing effective clinical treatments.
  • Further research into Lp(a) mechanisms will facilitate the translation of novel therapies into clinical practice.

Keywords:
Lipoprotein(a)atherosclerosiscardiovascular riskcoronary artery disease

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